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Meta-Analysis
. 2018 Nov;21(4):146-154.
doi: 10.1136/ebmental-2018-300037. Epub 2018 Oct 25.

Sleep in youth with autism spectrum disorders: systematic review and meta-analysis of subjective and objective studies

Amparo Díaz-Román #  1 , Junhua Zhang #  2   3 , Richard Delorme  4   5 , Anita Beggiato  4   5 , Samuele Cortese  3   6   7   8   9
Affiliations
Meta-Analysis

Sleep in youth with autism spectrum disorders: systematic review and meta-analysis of subjective and objective studies

Amparo Díaz-Román et al. Evid Based Ment Health. 2018 Nov.

Abstract

Background: Sleep problems are common and impairing in individuals with autism spectrum disorders (ASD). Evidence synthesis including both subjective (ie, measured with questionnaires) and objective (ie, quantified with neurophysiological tools) sleep alterations in youth with ASD is currently lacking.

Objective: We conducted a systematic review and meta-analysis of subjective and objective studies sleep studies in youth with ASD.

Methods: We searched the following electronic databases with no language, date or type of document restriction up to 23 May 2018: PubMed, PsycInfo, Embase+Embase Classic, Ovid Medline and Web of Knowledge. Random-effects models were used. Heterogeneity was assessed with Cochran's Q and I2 statistics. Publication (small studies) bias was assessed with final plots and the Egger's test. Study quality was evaluated with the Newcastle Ottawa Scale. Analyses were conducted using Review Manager and Comprehensive Meta-Analysis. FINDINGS: From a pool of 3359 non-duplicate potentially relevant references, 47 datasets were included in the meta-analyses. Subjective and objective sleep outcome measures were extracted from 37 and 15 studies, respectively. Only five studies were based on comorbidity free, medication-naïve participants. Compared with typically developing controls, youth with ASD significantly differed in 10/14 subjective parameters and in 7/14 objective sleep parameters. The average quality score in the Newcastle-Ottawa Scale was 5.9/9.

Discussion and clinical implications: A number of subjective and, to a less extent, objective sleep alterations might characterise youth with ASD, but future studies should assess the impact of pharmacological treatment and psychiatric comorbidities.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
PRISMA flow chart. *Reasons for exclusion for each paper are reported in the online supplemental material 2. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
See this image and copyright information in PMC

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